Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study
Objective To identify aetiologies of childhood community-acquired pneumonia (CAP) based on a comprehensive diagnostic approach.Design ‘Partnerships for Enhanced Engagement in Research-Pneumonia in Paediatrics (PEER-PePPeS)’ study was an observational prospective cohort study conducted from July 2017...
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e057957.full |
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| author | Rina Triasih Yan Mardian Dewi Lokida Helmia Farida Herman Kosasih Adhella Menur Naysilla Arif Budiman Chakrawati Hayuningsih Moh Syarofil Anam Dwi Wastoro Mujahidah Mujahidah Setya Dipayana Amalia Setyati Abu Tholib Aman Nurhayati Lukman Muhammad Karyana Ahnika Kline Aaron Neal Chuen-Yen Lau Clifford Lane |
| author_facet | Rina Triasih Yan Mardian Dewi Lokida Helmia Farida Herman Kosasih Adhella Menur Naysilla Arif Budiman Chakrawati Hayuningsih Moh Syarofil Anam Dwi Wastoro Mujahidah Mujahidah Setya Dipayana Amalia Setyati Abu Tholib Aman Nurhayati Lukman Muhammad Karyana Ahnika Kline Aaron Neal Chuen-Yen Lau Clifford Lane |
| author_sort | Rina Triasih |
| collection | DOAJ |
| description | Objective To identify aetiologies of childhood community-acquired pneumonia (CAP) based on a comprehensive diagnostic approach.Design ‘Partnerships for Enhanced Engagement in Research-Pneumonia in Paediatrics (PEER-PePPeS)’ study was an observational prospective cohort study conducted from July 2017 to September 2019.Setting Government referral teaching hospitals and satellite sites in three cities in Indonesia: Semarang, Yogyakarta and Tangerang.Participants Hospitalised children aged 2–59 months who met the criteria for pneumonia were eligible. Children were excluded if they had been hospitalised for >24 hours; had malignancy or history of malignancy; a history of long-term (>2 months) steroid therapy, or conditions that might interfere with compliance with study procedures.Main outcome(s) measure(s) Causative bacterial, viral or mixed pathogen(s) for pneumonia were determined using microbiological, molecular and serological tests from routinely collected specimens (blood, sputum and nasopharyngeal swabs). We applied a previously published algorithm (PEER-PePPeS rules) to determine the causative pathogen(s).Results 188 subjects were enrolled. Based on our algorithm, 48 (25.5%) had a bacterial infection, 31 (16.5%) had a viral infection, 76 (40.4%) had mixed bacterial and viral infections, and 33 (17.6%) were unable to be classified. The five most common causative pathogens identified were Haemophilus influenzae non-type B (N=73, 38.8%), respiratory syncytial virus (RSV) (N=51, 27.1%), Klebsiella pneumoniae (N=43, 22.9%), Streptococcus pneumoniae (N=29, 15.4%) and Influenza virus (N=25, 13.3%). RSV and influenza virus diagnoses were highly associated with Indonesia’s rainy season (November–March). The PCR assays on induced sputum (IS) specimens captured most of the pathogens identified in this study.Conclusions Our study found that H. influenzae non-type B and RSV were the most frequently identified pathogens causing hospitalised CAP among Indonesian children aged 2–59 months old. Our study also highlights the importance of PCR for diagnosis and by extension, appropriate use of antimicrobials.Trail registration number NCT03366454 |
| format | Article |
| id | doaj-art-98a469ba06304bdaa22fe752a8f58bd5 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-98a469ba06304bdaa22fe752a8f58bd52025-01-24T04:55:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-057957Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective studyRina Triasih0Yan Mardian1Dewi Lokida2Helmia Farida3Herman Kosasih4Adhella Menur Naysilla5Arif Budiman6Chakrawati Hayuningsih7Moh Syarofil Anam8Dwi Wastoro9Mujahidah Mujahidah10Setya Dipayana11Amalia Setyati12Abu Tholib Aman13Nurhayati Lukman14Muhammad Karyana15Ahnika Kline16Aaron Neal17Chuen-Yen Lau18Clifford Lane19Rumah Sakit Umum Pusat Dr Sardjito, Sleman, DIY, IndonesiaIndonesia Research Partnership on Infectious Disease, Jakarta, IndonesiaTangerang District General Hospital, Tangerang, Banten, IndonesiaRumah Sakit Umum Pusat Dr Kariadi, Semarang, Central Java, IndonesiaIndonesia Research Partnership on Infectious Disease, Jakarta, IndonesiaIndonesia Research Partnership on Infectious Disease, Jakarta, IndonesiaTangerang District General Hospital, Tangerang, Banten, IndonesiaTangerang District General Hospital, Tangerang, Banten, IndonesiaRumah Sakit Umum Pusat Dr Kariadi, Semarang, Central Java, IndonesiaRumah Sakit Umum Pusat Dr Kariadi, Semarang, Central Java, IndonesiaRumah Sakit Umum Pusat Dr Sardjito, Sleman, DIY, IndonesiaRumah Sakit Umum Pusat Dr Kariadi, Semarang, Central Java, IndonesiaRumah Sakit Umum Pusat Dr Sardjito, Sleman, DIY, IndonesiaRumah Sakit Umum Pusat Dr Sardjito, Sleman, DIY, IndonesiaIndonesia Research Partnership on Infectious Disease, Jakarta, IndonesiaNational Institute of Health Research and Development, Ministry of Health, Republic of Indonesia, Jakarta, IndonesiaNational Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USANational Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USANational Cancer Institute, Bethesda, Maryland, USANational Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USAObjective To identify aetiologies of childhood community-acquired pneumonia (CAP) based on a comprehensive diagnostic approach.Design ‘Partnerships for Enhanced Engagement in Research-Pneumonia in Paediatrics (PEER-PePPeS)’ study was an observational prospective cohort study conducted from July 2017 to September 2019.Setting Government referral teaching hospitals and satellite sites in three cities in Indonesia: Semarang, Yogyakarta and Tangerang.Participants Hospitalised children aged 2–59 months who met the criteria for pneumonia were eligible. Children were excluded if they had been hospitalised for >24 hours; had malignancy or history of malignancy; a history of long-term (>2 months) steroid therapy, or conditions that might interfere with compliance with study procedures.Main outcome(s) measure(s) Causative bacterial, viral or mixed pathogen(s) for pneumonia were determined using microbiological, molecular and serological tests from routinely collected specimens (blood, sputum and nasopharyngeal swabs). We applied a previously published algorithm (PEER-PePPeS rules) to determine the causative pathogen(s).Results 188 subjects were enrolled. Based on our algorithm, 48 (25.5%) had a bacterial infection, 31 (16.5%) had a viral infection, 76 (40.4%) had mixed bacterial and viral infections, and 33 (17.6%) were unable to be classified. The five most common causative pathogens identified were Haemophilus influenzae non-type B (N=73, 38.8%), respiratory syncytial virus (RSV) (N=51, 27.1%), Klebsiella pneumoniae (N=43, 22.9%), Streptococcus pneumoniae (N=29, 15.4%) and Influenza virus (N=25, 13.3%). RSV and influenza virus diagnoses were highly associated with Indonesia’s rainy season (November–March). The PCR assays on induced sputum (IS) specimens captured most of the pathogens identified in this study.Conclusions Our study found that H. influenzae non-type B and RSV were the most frequently identified pathogens causing hospitalised CAP among Indonesian children aged 2–59 months old. Our study also highlights the importance of PCR for diagnosis and by extension, appropriate use of antimicrobials.Trail registration number NCT03366454https://bmjopen.bmj.com/content/12/6/e057957.full |
| spellingShingle | Rina Triasih Yan Mardian Dewi Lokida Helmia Farida Herman Kosasih Adhella Menur Naysilla Arif Budiman Chakrawati Hayuningsih Moh Syarofil Anam Dwi Wastoro Mujahidah Mujahidah Setya Dipayana Amalia Setyati Abu Tholib Aman Nurhayati Lukman Muhammad Karyana Ahnika Kline Aaron Neal Chuen-Yen Lau Clifford Lane Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study BMJ Open |
| title | Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study |
| title_full | Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study |
| title_fullStr | Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study |
| title_full_unstemmed | Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study |
| title_short | Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study |
| title_sort | epidemiology of community acquired pneumonia among hospitalised children in indonesia a multicentre prospective study |
| url | https://bmjopen.bmj.com/content/12/6/e057957.full |
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